DiversityNursing Blog

By RWJF

Barbara Nichols, a national nurse leader who broke through color barriers to become the first Black president of the American Nurses Association, likes to point out that she entered the profession in its dinosaur days—before the advent of cardio-pulmonary resuscitation, intensive care units, and pre-mixed narcotics.

It was also prehistoric in another way; Nichols became a nurse in the 1950s, when a national system of institutionalized discrimination kept minorities from entering and advancing in nursing.

In those days, many hospitals were segregated, as were many nursing schools. Those schools that weren’t often capped the number of students from racial, ethnic, and religious minority backgrounds with rigid quota systems. Few minority nurses earned baccalaureate or advanced degrees, and fewer still rose to become leaders of the profession.

But Nichols overcame those hurdles and eventually made history as the first Black nurse to hold national and state-level nursing leadership positions. Throughout her career, she has been helping others from underrepresented backgrounds enter and advance in the profession—a mission she continues at the age of 75 as director of a diversity initiative in her home state of Wisconsin.

“My whole career has been spent raising the issue of the need for racial and ethnic inclusion and looking for specific ways to involve and include more minorities in nursing,” she says. “That has been my passion.”

Born during tail end of the Great Depression and raised in Maine, Nichols was active in children’s theater and considered becoming an actor; but she ultimately decided against it because of limited professional acting roles for Blacks. Instead, she pursued a different, more “practical” dream, and became a nurse. “I was born in the late 30s, and the job market and occupations for Blacks were very limited,” she recalls. “Pragmatically, nursing was one of the fields you could go into.”

Not that it was easy. Nichols landed a highly coveted spot at Massachusetts Memorial School of Nursing in Boston, where she was one of only four Black students in her class. She went on to earn her bachelor’s degree in nursing at Case Western Reserve University, where she was one of two Black students in her class. She took a job at Boston Children’s Hospital, where she was the only Black registered nurse (RN) on staff. She then joined the U.S. Navy, where she was one of a handful of Black nurses on a staff of 150.

But life as “a speck of pepper in a shaker of salt,” as one reporter put it, never held her back; rather, it propelled her forward as a nurse leader and advocate for diversity in nursing. As a young staff nurse, she recalls, her suggestions were ignored because of her race. “Nurses would say, ‘Well, who are you to tell us what to do,’” she recalls. “That’s when I decided to get into a leadership role. It was a direct result of being ignored, and of the impression I got that my ideas weren’t worthy of consideration because I was Black.”

And lead she did. In 1970, Nichols became the first Black woman to serve as president of the Wisconsin Nurses Association. To this day, she is still the only ethnic minority to serve as the organization’s president in its more than 100 years of existence. In 1979, Nichols went on to become the first Black president of the American Nursing Association—an organization that once banned Blacks—and served for two terms. In 1983, she became the first Black woman to hold a cabinet-level position in the state of Wisconsin when she was appointed to serve as secretary of the Wisconsin Department of Regulation and Licensing. She was named a Living Legend by the American Academy of Nurses in 2010.

“I’ve been a role model who says that Blacks can achieve and can participate in meaningful ways in issues that are central to the profession,” she says.

A Long Way to Go

A lot has changed since Nichols first entered the profession. Nursing schools are no longer segregated and no longer use quotas. Employers are working harder to recruit and retain nurses of color, she adds, and more nurses from underrepresented backgrounds are seeking higher degrees.

But there’s still a ways to go before the nursing workforce reflects the increasingly diverse population it serves. The RN workforce is 75 percent White, almost 10 percent Black. and less than 5 percent Latino, according to a 2013 report by the Health Resources and Services Administration. A more diverse nursing workforce is needed to provide culturally relevant care, improve interaction and communication between providers and patients, and narrow health disparities, according to the Institute of Medicine (IOM).

After six decades in nursing, Nichols is not giving up. A visiting associate professor at the University of Wisconsin-Milwaukee College of Nursing, Nichols recently took a position as project coordinator for the Wisconsin Action Coalition to help diversify the state’s nursing workforce. Action Coalitions are the driving force of the Future of Nursing: Campaign for Action, which is backed by the Robert Wood Johnson Foundation and AARP and aims to transform the nursing profession to improve health and health care. It is grounded in anIOM report on the future of nursing released in 2010.

“Our goal is to embed, and ground, all our activities with a diversity component,” Nichols said. To do that, she and her colleagues are gathering data about the diversity of Wisconsin’s nursing workforce, partnering with interested parties, raising money to sustain efforts to diversify the profession, and analyzing ways to promote diversity through policy and practice.

She also supports the Campaign’s national efforts to implement diversity planning, recruit and retain students and faculty from underrepresented groups, and promote advanced education and leadership development among minority nurses.

 “We have a big job ahead of us,” Nichols says, adding: “Prejudice is still out there.”

Source: RWJF

By Jackie Farwell, BDN Staff

After a routine mammogram in the fall of 2011, Laurie Thornberg learned she had breast cancer. Over the next nine months, as the Oakland woman endured surgery and rounds of chemotherapy, she watched as friends and loved ones attempted to explain her condition to their children.

Some struggled. One person described Thornberg’s cancer to her children “like I had the plague,” she said. Others were more comfortable, including a close friend and neighbor Thornberg ran into while out for a walk.

“[She] told her children in a kind and gentle way,” Thornberg, a registered nurse, wrote in an email.

Thornberg chronicled the encounter with her neighbor in her new children’s book, “Julie’s Dream,” which she hopes families will use as a tool to talk with their children about cancer and its treatment, as well provide hope to cancer victims and their loved ones.

“Children, even young ones, can be very aware of their surroundings and have questions when they notice family members being upset, someone who is sick a lot, or even as simple as a person suddenly has no hair,” Thornberg said.

In the book, Thornberg’s neighbor explains to her children, “See our friend? She wears that bonnet to cover her head because she got sick and had to take a special medicine that made her hair fall out.”

One of the children turns to Thornberg, asking, “Why don’t you take off that bonnet? I’m sure you’re beautiful under there.”

The book goes on to detail the main character’s dream about magically being healed. Thornberg’s friend and the book’s illustrator, Juliana Muzeroll, had that very dream about her, Thornberg said.

“I liked this approach a lot because it gives the reader freedom to interpret the outcome to fit their own personal situation,” she said. “Meaning, that whether the loved one survives or passes away, there is always healing at the end of a cancer journey.”

Thornberg remains in remission 18 months after her last round of chemotherapy. She now realizes that the disease freed her from stressing over the demands of a life as a full-time hospital nurse, mother, and daughter caring for her disabled mother, said Thornberg, who now works in home health care and said she’s able to focus on what’s really important in life.

“Getting cancer took me away from my excessive stress,” she said. “I often say ‘cancer healed my life.’”

“Julie’s Dream” is available in softcover or as an e-book on amazon.com, barnesandnoble.com, and authorhouse.com, by searching the title and author together.

Source: Bangor Daily News

By Don Walker of the Journal Sentinel

Rita Higgins was caring for Natalie Engeriser, her 11-year-old patient, when Natalie's mother, Katie, walked into a hospital room on the seventh floor of Children's Hospital of Wisconsin.

There's some kind of disturbance in the hallway, Natalie's mother told Higgins Thursday.

"When she said 'disturbance,' I was thinking one of the kiddos was having a hard time," Higgins said Saturday.

"I stepped into the hallway and I immediately realized something was wrong," Higgins said. "There were two nurses at the nursing station and by the looks on their faces, I knew something was wrong. I heard one of the nurses say, 'Oh my God, they are shooting. Call an active-shooter code.'"

A man police later identified as Ashanti Hendricks was armed and police were trying to arrest him. But Higgins, 37, a registered nurse who started working at Children's last February, didn't really know what was unfolding.

But Higgins, a mother of two just starting her third career, knew what to do, as did the rest of the medical staff.

"I immediately turned back around and I said to Natalie, 'Honey, I'm going to need you to get out of bed and me and your mom are going to help you get into the bathroom.' I was going to need them to go into the bathroom and lock the door behind them," she said.

Higgins wanted to be sure she didn't scare Natalie. The girl is one of Higgins' favorite patients. In fact, when Higgins arrived for work on Thursday, she had been assigned a different floor. Higgins was disappointed because she liked working with Natalie and had made strides in her care.

"A co-worker saw how disappointed I was," Higgins said. "A fellow nurse traded with me, basically. She said, 'Hey, Rita, I know you want to take care of Natalie.'"

Later, as the hospital went into lockdown, she was unsure what was unfolding on the unit. That's when she helped get Natalie out of harm's way.

"We got her and the medical equipment in the bathroom with mom," Higgins said. "I told her to lock the door. I looked them straight in the face and said, 'Don't open the door until I tell you to open the door.' I looked at Natalie and said, 'It's going to be OK.' And I closed the door."

At Children's, doors to the hospital rooms don't lock. But next to the closed door was a small window. As Higgins stood guard, protecting a mother and her little girl, she managed to peer out, trying to make sense of the noise, the chaos.

"Looking back on it, in the period of time when we truly did not know what was going on, we didn't know if someone was just literally shooting, and we didn't know police were involved," Higgins said. "There was that unknown period of time when you think, 'Is this door going to open with a guy with a gun?'"

"For all three of us, that was pretty horrible. All I know is that someone was on the unit with a gun. Shots had been fired," Higgins said.

At some point Higgins saw another nurse in the hallway who was watching a TV monitor where she could see police handcuffing the man elsewhere on the floor.

"That's when I stepped out of the room, looking at the monitor," Higgins said. "Seconds later, I heard more scuffling and the man was suddenly running onto my side down the hall and past me. I went back in the room and closed the door."

Police finally subdued him.

"I knew it was loud and so much stuff was going on," she said. "God knows what (Natalie and her mom) were thinking.

"I told them I was going to stay in here. I told them a bad guy was captured. I told them they were going to hear a lot of stuff."

Natalie and her mother came out of the bathroom. Higgins told Natalie and her mother to turn on the television and turn the volume up loud. Drown out the noise outside.

Two days after the ordeal, Higgins was full of praise for Natalie, her mother and the other nurses on the floor who performed calmly, admirably and courageously.

"I was thinking I was glad I stayed on the floor that day and that I was able to be there for Natalie," Higgins said. "You build up trust and she trusted me."

Later that night, when Higgins was about done for the day, a music therapist came with a guitar to visit Natalie.

The therapist played the Katy Perry hit, "Firework."

"That's the way I ended my shift, rocking out with Natalie with 'Firework,'" Higgins said.

Source: Milwaukee Wisconsin Journal Sentinel

Kelly Kennedy, USA TODAY

Source: The Salt Time Tribune

By Debra Wood, RN

To achieve the national goal of improved health outcomes, many researchers and health advocates agree that patients must assume a greater role in managing their health

care. But how can facilities and health systems accomplish this kind of patient engagement? The answer may rest with nurses and nurse leaders, who have long overseen patient education about how to care for chronic conditions and make lifestyle changes to improve health.

“Promoting patient education has always been a part of our nursing role and obligation to the
patient,” said Debi Sampsel, DNP, MSN, BA, RN, chief officer of innovation and entrepreneurship at the University of Cincinnati’s College of Nursing in Ohio. “It has been a long-standing practice that nurses involve the patient across the life span in their own care.”

Sampsel finds nurses strive to and take great pride in promoting healthy lifestyles. And research has demonstrated that active, engaged individuals have far better health outcomes. The University of Cincinnati includes health promotion in the nursing curriculum and gives students an opportunity gain patient-engagement experience while working with the homeless and elementary and secondary school age youth.

“What’s new is old,” added Patrick R. Coonan, EdD, RN, NEA-BC, FACHE, dean and professor at the College of Nursing and Public Health at Adelphi University in Garden City, N.Y. “I went to nursing school 35, 40 years ago and what did they teach but to be the patient advocate, to teach the patient. But we got away from that in the last few decades.”

Coonan pointed out that today’s consumers and patients, particularly baby boomers, are better informed. They often turn to the Internet for facts, but he called it a nursing professional’s obligation to verify whether the online information is accurate. Boomers are not going to settle for a paternalistic “Just take this pill” without knowing why and how it will benefit them. And that often falls to the nurse.”

“We have to get away from the patient-doctor or patient–nurse relationship that is almost like a parent–child relationship, in existence for many years, to a more informed and empowered [consumer] who will take responsibility for their health,” said Rosemary Glavan, RN, MPA, CCM, senior vice president of clinical operations at AMC Health, a telehealth provider based in New York. “Baby boomers have been go-getters and always wanted to be in charge. They want to be empowered.”

Advocating with a personal connection

“As patient advocates, nurses and nurse leaders play a key role in promoting patient engagement,” said Cynthia M. Friis, MEd, BSN, RN-BC, associate association executive for SmithBucklin’s healthcare and scientific industry practice in Chicago. “Nurses are privileged with having the opportunity to spend more time with the patients to assess, plan, implement and then help clarify the plan of care with the patient and his/her family or caregivers. Nurse leaders are key in helping to ensure this role is realized. Nurses can do their jobs better with the full support of our nurse leaders.”

Nurses ask questions, she added, and draw patients into thoughtful discussions about their care, helping them move forward when they feel overwhelmed and understand how to best care for themselves.

Establishing principles of engagement

Patewood Memorial Hospital in Greenville, S.C., participated in a national study by the Agency for Healthcare Research and Quality (AHRQ) and in the development of theGuide to Patient and Family Engagement in Hospital Quality and Safety.

Recommendations in the AHRQ guide include:

• Working with patients as advisors;
• Communicating effectively; 
• Giving bedside shift reports, where nurses do not talk with each other but involve the patient and family members he or she wants to participate; and 
• Engaging patients in transitions to home.

The hospital has experienced improvements to its HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey since implementing the program.

“The patients and families are much happier,” said Kerrie Roberson, MBA, MSN, RN-BC, CMS, nurse educator at Patewood. “Patient engagement is a partnership with the patient and families, and they trust you more when they see you are open about their care.”

Nurses at Patewood are leading discussions about patient engagement across the Greenville Health System and have begun sharing their experiences with others.

Other nurses gathered to develop Guiding Principles for Patient Engagement, released last year by the Nursing Alliance for Quality Care (NAQC), which was supported by the Robert Wood Johnson Foundation.

Principles in the NAQC guide include:

• Having a dynamic partnership with patients and their families; 
• Respecting boundaries; 
• Maintaining confidentiality; 
• Adhering to responsibilities and accountabilities; 
• Recognizing patients able to engage; 
• Appreciating patient rights; 
• Sharing information and decision making; and 
• Advocating for the patient.

“Patient-centered care and engaging patients is very important to improving quality outcomes, which includes reducing cost and better health of populations in the community, but also reductions in disparities of care,” said Maureen Dailey, PhD, RN, CWOCN, senior policy fellow for nursing practice and policy at the American Nurses Association (ANA), a member organization of the NAQC. “The patient is at the center of the team and must assume accountability for self-care and part of the outcome. But that evolution has yet to take place.”

Nurses must instill confidence and competence in patients’ self-care, Dailey explained. And patients need nurses to provide knowledge, support and symptom management.

“Nurses hold a central role in patient engagement,” Dailey concluded.

Combing nursing skills with technology

Along with the personal touch, many nurses are finding technology can assist with their patient-engagement efforts.

“As the responsibility of nursing advances to one of building and sustaining patient activation and the role of nursing moves to be more consultative across care settings, technology will play a vital role for both the nurse and the patient,” said Karen Drenkard, PhD, RN, NEA-BC, FAAN.

Drenkard, who has served as executive director of the American Nurses Credentialing Center (ANCC) and past director of the ANCC Magnet Recognition Program, will join GetWellNetwork in January as chief clinical/nursing officer, where she will lead the development of a nursing model of patient engagement. Her responsibilities will include studying and designing new ways to assess and improve patient activation through clinical practice and technology solutions across all care settings.

“Nursing can use interactive patient care technology to proactively engage the patient and shift the responsibility for completing certain care interventions,” said Drenkard, explaining patients can document daily signs and symptoms. Care providers use the network to send reminders about taking medications or the need for follow-up visits to their physician when data and input from the patient indicates the need to do so.

By Sarah Cutrufello, RN, MSN, OCN

As an oncology nurse, I witness how ordinary people living with cancer cope with their extraordinary disease; how common people summon the uncommon strength to receive the toxic cocktail of chemicals that medical professionals call “treatment.” Each case is different, each patient unique.

About two years ago, I was fortunate to develop a relationship with a woman who had a special way — quiet, gentle, dignified — of handling her disease. At 66, she had been diagnosed with acute myelogenous leukemia. 

When we first met, she looked up at me from her hospital bed and solemnly said, “I should be in Switzerland today … .” Her husband finished the thought — they had booked a week-long trip to Germany and Switzerland. Recently retired, the couple had reserved a place in their minds for that special spot to drink tall glasses of wine in a cabin overlooking the Alps. 

Yet here they were, in a hospital room in Philadelphia. Their updated itinerary consisted of eating tasteless scrambled eggs and lying on an uncomfortable mattress overlooking the brick buildings of the hospital’s sprawling city complex. It was not fair. 

In that moment of our first meeting, I felt a profound sadness. This woman had an exciting life that she shared with her husband, who one could instantly tell was head over heels for his wife. Cancer was robbing her of this life.

She never said she was scared or upset or angry. She was appreciative of everything I did. When the physician’s team came in, she fooled them with her sweet smile and upbeat attitude. It almost was worthy of some kind of perverse Oscar award for “Best Performance in a Terminally Ill Role.” 

But I could see through the act to the deep pain and hurt of the “actress” lying in bed; someone who was struggling to come to terms with the fact that as recently as a month prior she was enjoying a vibrant life with her husband and friends back home.

A few weeks later, on St. Patrick’s Day, she could barely wait to tell me as I walked in, “I should be at a great party today.”

“A great party? Tell me about this party,” I said.

Her face lit up as she told me how her neighborhood opened its homes on St. Patrick’s Day to hold a sort of bar crawl. Again, though, there was the hint of disappointment. 

I listened with a smile on my face and said — as I always said when we talked about events she could no longer attend — “When you get out of here, you will do these things. I promise.” These words felt like equal parts truth, lies and hope mixed together in some kind of phrase that needs to be said on such occasions.

Later, as I was unhooking her blood transfusion, I noticed she had found a few moments to sleep. I stood there for a moment, silently, my eyes filling with tears. It occurred to me just how disappointed she must have been every time she woke up and was confronted with the reality that is cancer. 

She was not in Switzerland or Germany or enjoying a great St. Patrick’s Day party with friends. The life she had known before cancer stopped her in her tracks was happening someplace far removed from where she was. She would die about a year and a half after I met her. 

Above all else, this experience taught me the importance of approaching patients with open ears and an open heart. Dealing with anxiety, anticipation, fear, loneliness, uncertainty or any number of other emotions, our patients often need a kind of nursing care that goes beyond administering their prescribed treatment.

At the close of that day’s shift, I said to another clinician, “I feel her sadness. She breaks my heart.” To which the other person gave a quick chuckle and said, “She’s not sad.” 

I thought to myself: another Oscar-worthy performance. 

Source: Nurse.com

What is NO MORE?

NO MORE is a new unifying symbol designed to galvanize greater awareness and action to end domestic violence and sexual assault.  Supported by major organizations working to address these urgent issues, NO MORE is gaining support with Americans nationwide, sparking new conversations about these problems and moving this cause higher on the public agenda.

The history of NO MORE

The NO MORE symbol has been in the making since 2009. It was developed because despite the significant progress that has been made in the visibility of domestic violence and sexual assault, these problems affecting millions remain hidden and on the margins of public concern. Hundreds of representatives from the domestic violence and sexual assault prevention field came together and agreed that a new, overarching symbol, uniting all people working to end these problems, could have a dramatic impact on the public’s awareness.

The signature blue vanishing point originated from the concept of a zero – as in zero incidences of domestic violence and sexual assault. It was inspired by Christine Mau, a survivor of domestic violence and sexual abuse who is now the Director of European Designs at Kimberly-Clark. The symbol was designed by Sterling Brands, and focus group tested with diverse audiences across the country who agreed that the symbol was memorable, needed and important.

Who is behind NO MORE?

Every major domestic violence and sexual assault organization in the U.S. – from men’s organizations like A CALL TO MEN and Men Can Stop Rape, to the National Domestic Violence Hotline and the National Alliance to End Sexual Violence, to groups that help teens like Break the Cycle and Futures Without Violence, to organizations that advance the rights of women of Color and immigrants like Casa de Esperanza and SCESA to the U.S. Dept. of Justice’s Office on Violence Against Women – all of them and more are behind NO MORE.

View the complete list of organizations here.

What do we do?

NO MORE is spotlighting an invisible problem in a whole new way. The first unifying symbol to express support for ending domestic violence and sexual assault, NO MORE can be used by anyone who wants to normalize the conversation around these issues and help end domestic violence and sexual assault. Our vision is that NO MORE will be everywhere – on websites, t-shirts, billboards. Organizations and corporations, large and small, will embrace this symbol as their own. When an abuse case makes media headlines, you will instantly see NO MORE being tweeted, discussed on Facebook, worn as jewelry and on t-shirts; made into buttons and posted in classrooms, offices, billboards and grocery stores across the country. NO MORE will help end the stigma, shame and silence of domestic violence and sexual assault. NO MORE will help increase funding to prevent domestic violence and sexual assault.  Like the pink ribbon did for breast cancer and the red ribbon did for HIV/AIDS, NO MORE will help to change behaviors that lead to this violence.

Get the symbol today and start showing your support.

Why should I care?

The next time you’re in a room with 6 people, think about this:

• 1 in 4 women experience violence from their partners in their lifetimes.
• 1 in 3 teens experience sexual or physical abuse or threats from a boyfriend or girlfriend in one year.
• 1 in 6 women are survivors of sexual assault.
• 1 in 5 men have experienced some form of sexual victimization in their lives.
• 1 in 4 women and 1 in 6 men were sexually abused before the age of 18.

These are not numbers. They’re our mothers, girlfriends, brothers, sisters, children, co-workers and friends. They’re the person you confide in most at work, the guy you play basketball with, the people in your book club, your poker buddy, your teenager’s best friend – or your teen, herself. The silence and shame must end for good.

How can I help?

There are hundreds of ways you can spread the word about NO MORE.

Say it: Learn about these issues and talk openly about them. Break the silence. Speak out. Seek help when you see this problem or harassment of any kind in your family, your community, your workplace or school. Upload your photo to the NO MORE gallery and tell us why you say NO MORE.

Share it: Help raise awareness about domestic violence and sexual assault by sharing NO MORE. Share the PSAs. Download the Tools to Say NO MORE and share NO MORE with everyone you know. Facebook it. Tweet it. Instagram it. Pin it.

Show it: Show NO MORE by wearing your NO MORE gear everyday, supporting partner groups working to end domestic violence and sexual assault and volunteering in your community.

Learn more here.

As nurses we are taught that we are professionals and we must maintain a certain emotional distance with our patients. It’s a boundary that encompasses the therapeutic relationship: nurses as caregivers, patients as the recipients of the care. But now, working as a nurse, I have found that while most of my professional boundaries are well defined, sometimes the line between a professional and personal relationship with a patient can become blurred.

I work on an orthopedic surgical unit where most patients are coming in and going out very frequently. That makes it hard to get to know anyone too well. But there are some patients that we never forget, for good or bad reasons. Most of the time these patients stay with us because, for whatever reason, one of us crossed the invisible boundary nurses set for themselves.

Recently, I cared for two patients who touched me so deeply it was impossible to maintain a professional distance. My grandfather had recently passed away, and both of these men reminded me of him. My grandfather, or “Grand-Daddy” as we all called him, was one-of-a-kind, and one of the kindest and most generous people I’ve ever met. He was hard of hearing but constantly fiddled around with his hearing aids, so it was wise to always be prepared to repeat yourself once or twice. He had an extraordinary memory until the day he died, and was one of the funniest people I’ve ever known.

One day at work, an older man arrived on my floor after a total hip replacement. As I worked to admit him to our care, his room was crowded with half a dozen family members who surrounded him with love. I asked him about his family, and he told me about his eight children, 30 grandchildren, and a couple of great-grandchildren too. It was uncanny how much this man reminded me of my grandfather, who also had a large family of six children, 28 grandchildren and three great grandchildren.

I smiled as I watched my patient fiddle with his hearing aids, and tears welled up in my eyes as he answered all of my questions with a familiar, “What did you say?” I didn’t mind repeating myself, and for a moment, it was as if I was speaking with my grandfather again.

After I was finished admitting him and settling him in, I found myself constantly peeking back into his room asking if he was O.K. and if he needed anything. He was pretty low-maintenance and never really needed much, and eventually, he was gone. I never told him that he reminded me of my grandfather, or how he tugged at my heartstrings, and I often wonder if I should have. But I worried that in showing this man a little extra attention, I had somehow breached the therapeutic relationship.

Not long after that, another patient came up to the floor. The report said he was an older man who was in “comfort care.” This essentially means that no lifesaving efforts would be made on his behalf; we were there to keep him comfortable during his final days. When this patient came up to the floor, I was quite taken by him. His gruff, Irish exterior belied his sweet nature. Medically, he had a lot of issues, but when he came up to the floor, the only thing he wanted was a bowl of oatmeal. When his tray came, he found cream of wheat instead. He was so disappointed, but I was determined to find him a bowl of oatmeal.

Miraculously, after a search through our floor kitchen, I found oatmeal and delivered it to him. He was delighted and blew me a kiss and gave me a wink. His chart said he needed assistance to eat, but he dug right in. Sure, he made a mess, but he managed just fine on his own.

Watching him eat that oatmeal reminded me of some of my last meals with Grand-Daddy. Grand-Daddy never was the neatest eater, and we would always laugh about what a mess he made. But he didn’t care — at his age, he just wanted what he wanted when he wanted it. My patient’s personality was strikingly similar to that of my grandfather. As he lay curled up in the bed, I thought about the strong man he must have been a long time ago.

When his wife and children came to the room, I felt a pang of familiarity. His wife remained so graciously composed during her visits. It brought back memories of my grandmother during my grandfather’s last days. Despite her deep sadness and fear of what was to come, my grandmother kept full composure and took care of not only him but also everyone around her. I still am amazed by how strong and selfless she was during that time: a true role model for unconditional love, and I saw these saintly qualities in this man’s wife.

The following day, the man was sent back to a nursing home where comfort care would be resumed. When the transporters came to get him, I started to feel emotional, like someone I loved was going to leave me. Even though I knew he was going to a nice and comfortable facility, I didn’t want him to go. We transferred him onto the stretcher and I made him cozy in his blankets. His family was sincerely thankful, and I remember telling them with tears in my eyes how much we enjoyed taking care of him, and how much we would miss him.

The tears continued to well up as I watched his stretcher go around the corner and out of sight, because I knew I would never see him again. I felt like I was saying goodbye not only to him, but also to my grandfather all over again. But once again, I stopped myself from sharing these feelings with my patient or his family. They knew I cared, but they never knew how much caring for him meant to me personally.

Looking back, I still don’t know if I did the right thing, keeping my feelings to myself. I now realize that both of these patients were helping me heal, even as I was helping them. Watching them leave was like letting go of my grandfather again, but they also gave me the gifts of laughter and reminiscence, right when I needed them most.

I know that, ultimately, I am still just the nurse, and they are still just my patients. But I think it’s better for both the patients and myself if we both sometimes allow ourselves to feel something more than a professional bond. Nurses and patients move in and out of each others’ lives so quickly, but we are nonetheless changed by every encounter.

I became a nurse because I want to care for people and make a difference. Being touched in return is an added bonus.

Source: The New York Times